So what can you do about hypertension?

Fortunately there are numerous action steps you can take to manage hypertension which include diet, supplements and lifestyle factors. Hypertension is part of metabolic syndrome which is very much a lifestyle disease. Thus diet has a strong impact on the incidence and management of hypertension.  We will concentrate on diet changes that can help lower BP (blood pressure) in this article. We will run a second article to cover supplements and lifestyle factors that can help reduce blood pressure.

What Diet Changes can you make to reduce and manage your BP?

• Reduce Sugar and Refined Carbohydrates: Multiple studies have found that reducing sugar intake in all forms leads to lower blood pressure (6, 7, 8).
• Sodium and Potassium: Despite conventional wisdom, studies have found that too much or too little sodium can increase blood pressure in some individuals (9). For most healthy individuals, we recommend consuming between 3’000 and 6’000 mg of sodium per day (9). Below 3’000 mg of sodium per day was associated with a 27% increase in cardiovascular disease and death (9). Consuming more than 6’000 mg per day was associated with a 15% increase in cardiovascular disease and mortality (9). It appears that there are a subset of sodium-sensitive individuals whose BP increases from excessive sodium intake. However, this is not everyone. We recommend that those with high blood pressure do an experiment with salt and measuring BP (see action steps at the end of this article). In addition to sodium, other minerals like potassium have a significant influence on BP as well. Another study found diets rich in potassium to be more effective than an aggressive salt reduction to prevent hypertension (10).  Recommended potassium intake per day is 4’000-5’000 mg but the average person only gets 2’800 mg daily (11). Increase your potassium by eating high potassium foods like banana, sweet potato, white potato, orange, winter squash, white beans, beets, parsnip and spinach.  It may be necessary to supplement potassium in addition to adding potassium to the diet.
  • (Note: One teaspoon of salt is approximately 2’300 mg sodium. One medium banana has 422 mg of potassium.)
• Magnesium and Calcium: Consuming a healthy diet that provides the recommended amount of the mineral magnesium can be help control BP (12). The RDA (Recommended Daily Allowance) for magnesium is 310–420 mg for adults and can be found in these foods high in magnesium: nuts, spinach & other greens, seeds, avocados, dark chocolate. Calcium, along with potassium and magnesium, may improve blood pressure levels and reduce coronary heart disease and stroke (13). It is recommended to get these minerals through increased consumption of fruits and vegetables (13). Calcium-containing foods include seeds, cheese, yogurt, bone-in fish like sardines, legumes, almonds and whey protein. The RDA for calcium varies depending on age and gender. Adults between 51 and 70 years are recommended to get 1’000- 1’200 mg per day.
• Reduce Alcohol: It is well established that excessive alcohol consumption is a significant predictor of the development of hypertension and that alcohol reduction in patients with high BP can significantly lower systolic and diastolic blood pressure (14).
• The DASH Diet: DASH or Dietary Approaches to Stop Hypertension is often regarded as the diet to follow for hypertension. In research, it has a reducing effect on both systolic and diastolic blood pressure but there is variation in the extent of the fall in blood pressure in different subgroups of patients (15). We think a generally healthy diet would be equally effective, as long as the sodium potassium balance is well managed and there are sufficient levels of other minerals.
• Specific Foods can help to reduce blood pressure include: hibiscus tea (16), beets (17), fatty fish such as salmon (18), olive oil (19) and nuts (20).
• Improve Gut Health: One study indicates that diet changes to re-balance gut microbiota could be a new strategy using nutrition to help reduce hypertension (5). This study goes on to say that probiotics affect BP. Trials showed a significant decrease in both systolic and diastolic BP in patients who took a daily dose of probiotics (21).

In Part 2 on Hypertension, we will discuss the supplements and some lifestyle factors that will significantly work to reduce hypertension. Please stay tuned for these tips.

Here are the abbreviated action steps you can take based on the information in this article:

• Significantly reduce sugar and refined carbohydrates by skipping dessert, avoiding pastries, cookies, cakes, and anything made with white flour. You can take it a step further if you like and avoid all gluten and sugar, choosing a moderate amount of fresh fruit and a small amount of raw, unfiltered local honey to satisfy any sweet needs. You could even try avoiding all grains for a period of time and use stevia as an alternative to sweeteners. Allow sweet potatoes, squash, beets, plantains, and carrots to become satisfying sweets. Possibly add a square or two of dark chocolate (75% and higher cocoa content) as this can help with nutrients that can regulate BP.
• Increase potassium intake by having plenty of starchy tubers like potatoes and sweet potatoes, plantains, avocados, bananas (eat them on the green side to have less blood sugar impact and get more resistant starch for good gut bacteria to feed on), and lots of leafy greens and some fresh fruits. Track with an app like MyFitnessPal for a few days and make sure you are getting at least 4’700mg/day. If BP is high, you may want to shoot for 6’000mg daily (some hunter-gatherer cultures have been reported to get as high as over 10’000mg daily on average).
• Do a salt experiment by taking precisely 1.5 teaspoons sea salt (just over 3’000mg on the low end of intake that was found to be in the healthy range for cardiovascular disease prevention) and putting it into a small dish. Make this your salt for the day. Cook all your meals at home and consume only food that has no added salt (nothing packaged that has any sodium content to it). Add salt from the dish to food you are cooking and to food on your plate that day. Make sure you have finished the salt in the dish by the end of the day (you will have to adjust things if you are cooking for more than just yourself so that you are getting the full dish worth of salt that day). Take your blood pressure first thing in the morning on this day and 2-3 times throughout the day. Notice if it is higher, lower, or the same as usual. Also keep a note on how it felt. Did that seem like a lot of salt? A small amount? Or about usual for you? Then do the experiment again another day but this time use 2.5 teaspoons of sea salt (just under the 6’000mg high end for healthy salt intake). How did your blood pressure do that day?
• Consume magnesium and calcium-rich foods and/or supplement to get adequate intake of both of these minerals. Be sure to have some nuts, seeds, plenty of greens including spinach, avocado, and some dark chocolate (1-2 squares at 75%+ cocoa content). Also get a couple of servings of grass-fed full fat dairy if you tolerate dairy (yogurt, kefir, cheese, etc.) and/or bone-in canned fish (canned wild salmon with the bone or canned sardines with the bones – the canning process makes the bones soft enough to eat – of course do not eat bones from fresh fish that are hard and brittle).
• Limit alcohol consumption to 3 drinks per week (men) or 2 drinks per week (women) or less. And make sure a drink is actually a single drink (i.e. 4 oz pour for wine and not 6 or 8 oz). If it has been a while since you’ve gone a month without alcohol, try stopping entirely for 30-60 days.
• Drink 2-3 cups of hibiscus tea daily by brewing a gallon of tea using loose leaf hibiscus flowers. Brew it strong and store in the fridge to drink over a few days.
• Eat fermented foods and/or take probiotics daily. For example you can eat sauerkraut, kimchi, fermented beets, make beet kvass and drink it, unsweetened grass-fed kefir, etc. Or get professional-grade probiotics to take. Also consume prebiotic rich foods like lentils, green bananas, green plantains, potatoes that have been cooked then cooled 24-hours, onions that are still a bit crunchy (not fully caramelized), leeks, and dandelion greens.

References

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